5 things I’d change about nursing schools

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The face of healthcare is evolving. We have the application of new healthcare systems, revamped healthcare insurance, an aging population and the increasing severity of illnesses, all of which require change.

Unfortunately, the profession of nursing is still playing catch-up. We seem to be stuck in a rut. Certain aspects of the traditional nursing education could use some attention and much-needed change. Here are five things I think nursing schools could address to meet these new challenges:

1. More time on evidence-based research, less time on care plans

While nursing schools emphasize the care we give on care plans, does anyone use them in practice? (I know I’ll hear a lot of grumbling from the educators out there for those words.) I firmly support the process by which care plans have helped put our knowledge into practice, but evidence-based practice is where the true measure of effect is seen in the delivery of our care.

2. More time on therapeutic communication, less time on bed baths

Don’t get me wrong: I think acquiring the skill of performing a bed bath is essential. It helps everyone learn good physical assessment skills. But if I have to choose between sharpening my bathing skills or effectively communicating with my patient and/or family, I’ll take the latter. Too often I find that nurses avoid necessary conversations simply because they don’t know how.

3. More time on professional development, less time on revering the past

I mean no disrespect, but it’s time to put the lamp on the shelf and take the next step in our evolution as a profession. We need to foster better professional skills and teach our nurses how to better navigate through their career paths, not just teach them how to get a job.

4. More time on team building (classroom and clinical), less time on individual performance

This is slowly happening, but we need to push it forward. We require our students to work on group projects as a means to build a team environment, but we need to step beyond the classroom and nurture their team building skills in the clinical settings. Teach them better task analyses, delegation, prioritization and, most importantly, firm and confident communication with other health care professionals.

5. More time on health care technology, less time on “writing narrative notes”

The electronic health record is now becoming the standard. We are delivering care with the aid of so many different pieces of technology that it’s hard to keep up with this exponential advancement. We need to build better confidence in using this technology so that we can be on the forefront of the next advancement.

It’s not a far leap, and it’s not a lot to ask. I strongly believe that the forefront of healthcare should and could be lead by nurses; we just have to stop playing catch-up.

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12 Responses to 5 things I’d change about nursing schools

  1. kjakewayrn

    I disagree with most of the above. As a nurse and as an instructor–these things are crucial but are not used to their advantage. Narrative charting teaches you how to give report. Pretty important to me.

  2. awesomet317

    Yep I agree with all of the above. Wish I could get back the countless wasted hours making care plans

  3. ccoleary2007

    I don’t agree or disagree with the above do to the fact that I do not have the experience.I am a third year nursing student. I do however agree with the fact that some students are at a disadvantage who spend an entire 5 month medical surgical rotation learning mostly bed baths, adls, and checking boxes next to an already written nursing diagnoses or care plan. I just think at this level we should be asked to assess a patient as a whole.We should be asked why? I think it would give us better skills and confidence moving forward. The clinic hours should be a growing experience for our hands on skills, but also our critical thinking skills in a setting that things can be complicated and where we see that patients are complex and they are unique. Writing out med cards is necessary but you don’t really connect the dots that way. The process of learning to be a nurse is a little antiquified and deserves to be built on in most of the areas Sean speaks about.
    Also some nursing instructors spend more time on this than others so it isn’t everyone, but the framework for our evaluation is so simple.

  4. mom23nursingstudent14

    I would prefer to have nursing instructors that are still working as nurses. My entire first year of nursing school was a mess, none of the instructors were working as nurses anymore and had no current knowledge on the new IV pumps, beds, EMR, med scanners, or vitals machines; whenever we had questions about any of these, we were required to seek help from the staff nurse or nursing assistant. My second year of nursing school, all of the instructors were still working at least part-time as nurses and had first-hand knowledge of the new technology that is available in the hospitals. It really made a world of difference.

    • fltNP

      You make a very valid point. I have seen professors teaching new nurses how to care for the sick and injured, but have never care for a patient since they were students. They went from their BSN program directly into a PHD program without ever working as a RN. We are doing you a disservice by allowing that, but once you’ve worked 3-12s making RN wages, it is difficult to justify the extra schooling and expense for a significant pay cut.

  5. Get_Fit

    I would add, as a current student, that the notion of “nurses eating their young” is insane. I truly can not believe there are still nurses so unwilling (or downright resentful) to help students who are there to learn and help! We are there to aspire to their level experience and wisdom yet are treated very disrespectful… not good professional modeling! I’m really not sure why this is the case. Many of the “nurses aids” are actually RNs who can not yet get nursing jobs. They are frustrated yet helpful, patient, encouraging, and skillful. I understand that it is hard to have us around but treat us with a bit of decency and patience. As a “non traditional” student I am eager to work really hard and study just as much. Guide me and I will make a great co-worker one of these days!

    • Elissa

      I agree and am so sorry there are still healthcare professionals with this attitude. I say the more the merrier, more work accomplished, knowledge is priceless. This saying has been around since I began in the nursing profession over 20 years ago. Don’t take it personnel ! There is a nurse or nursing assistant willing to help you… Kinda have to wade in the waters,do your job, remember no question is ever stupid! But by no means let anyone bully you. If you are having a problem with a certain person confront them in private. If the problem persists , speak to your supervisor for advice, don’t mention names. If all this fails time to report, hostile work environments are not productive and increase the rate of employee turnover.

  6. fltNP

    I could not agree more. I have not written a care plan or nursing diagnosis since nursing school. These very things, that my instructors expounded were foundations of nursing practice and making us professionals, are also the very things physicians degrade us over, particularly when we are not around. EBP is going the be the future of medicine in general and nursing would do well to adopt it completely and start teaching it from day one. I was so sick of Nightingale and Barton after school was done. I’m glad we have a history, but the education of nursing today, unfortunately misses a huge amount of it. How many educators know that nursing, at one time in history, was a male dominated role? Not many judging by the research paper I completed in school. Cover the lamp for a day, then move on to the real world where electricity is the standard.

    My only (semi) disagreement is writing narrative notes. Although EMR/EHR is the standard, there are still places using paper charting. Also, many EHR systems have areas for narrative notes. I’m sure you have all seen some atrocious writing skills, misspellings, horrific grammar, and general poor knowledge of how to write well. It would almost be beneficial to have a dedicated grammar and writing class to alleviate errors that make nurses seem like morons to other professionals reading those charts. If you cannot differentiate between their, there, and they’re or to, too, and two; how do you propose to defend yourself in court should something go wrong?

  7. Elissa

    I agree with all 5 points made. One I would add though is adding a class called nursing reality. No patient ,case,procedure , or illness is ever textbook. The very uncomfortable instances and choices nurses have to make independently. A person in any profession with a lack of common sense is useless. A lot of information needed to be a good nurse is not in a book. AND nursing must be a team effort!!!!

  8. Mommynator

    These are good observations, although I really do appreciate nursing history. One thing I would desperately wish for is more real experience with live humans on the ‘small’ procedures that are endlessly repeated like placing hep locks. Human simulators are fine to start with, but it would be nice not to walk into one’s first job with NO real experience on actual humans. Maybe it’s an insurance thing, but it’s a real issue and one reason preceptors have to roll their eyes.

  9. Zellanett

    As a nursing student I think that my school has #4 down. We have a huge simulation lab (basically a mock hospital) Where real life scenarios are played out for us and we have a team of three student nurses that function as one. One is the primary nurse, another is the secondary nurse. These two work together to get a complete assessment and pick up on what the other left off and the last is resource who documents and makes any needed calls to the doctor or the lab etc. I think if nothing else I have dramatically seen an improvement in my SBAR skills from Fundamentals to the the ADH2 course I am enrolled in currently.

  10. Ron Laran

    I would have liked to have some real training in nursing school on how to give end of shift reports. As a new nurse I feel completely unable to give an adequate shift report. We should have spent months in nursing school giving oral shift reports instead of pulling all-nighters writing ridiculous care plans we forgot all about the next day.